Breathing

Once the airway has been assured, the patient's chest is exposed to assess ventilation. The symmetry and extent of chest wall expansion can be checked by inspection. The adequacy of exchange in the lungs is initially evaluated by auscultation. Percussion may reveal the presence of air or blood in the chest. Palpation may reveal tender areas or crepitation, indicating fractures. A pulse oximeter should be applied rapidly. Decreased breath sounds on one side which persist even though checks have ensured that the endotracheal tube is not inserted too far, the presence of hypotension, neck vein distension, and deviation of the trachea suggest the presence of a tension pneumothorax. If there is hypotension with no neck vein distension, the trachea is midline, and the chest is dull to percussion, a significant hemothorax is likely to be present.

Sleep Apnea

Sleep Apnea

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